CMC Arthroplasty with STABLYX Implant

Posted by joynett @joynett, Nov 14, 2018

Hello! 😃 Has anyone had this procedure? I had the LRTI procedure on my left thumb/wrist 10 years ago with great results. But this time, my surgeon suggested the STABLYX implant due to my age and lifestyle. My surgery is scheduled for 11/21/2018 and would love to hear of anyone's experience who has had this procedure done. Thanks!

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@crnaretired

Stabylx Revision Update. About 4 weeks post op today. The experience of the Trapeziectomy w/ Arthrex mini-tightrope procedure has been very positive. Stabylx implant was removed and for the most part all the pain that was associated with that implant is finally gone. What a relief! The only pain I’m experiencing at this point is normal healing process stuff with the incision and some associated normal post op tightness with the APL tendon transfer. (apparently my FCR was absent when the surgeon opened me up- that’s a whole other post) Still using a OT (occupational therapy) rigid splint (got out of the post op splint after 10 days) with the option to take it off for, dressing, bathing and very light use or just resting. Could not be more pleased with the results of this revision as of this date. Highly recommend the Trapeziectomy w/ Arthrex mini tightrope procedure for advanced CMC arthritis related repair.

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I too had the Stabylx done 15 months ago and mine wasn’t as successful as others. Dr. told me that I was his 7th patient that was having trouble and that he quit doing the Stabylx because there is a design flaw. My hand is constantly in pain and slightly swollen. I had a steroid injection 4 mos. ago and what a relief it was, but it wore off. Had another injection about 10 days ago with zero relief. He did say that if I wanted he would take it out and do the same procedure you had but I am scared to do it because he said I will lose ROM which I currently have full ROM. My recovery from the Stabylx was long and hard and not thrilled about going thru all that again. I actually regret doing the first surgery. I am interested in how your recovery goes because there is going to come a point when the pain can’t be managed and I will need to make a decision on having it removed and doing the Trapeziectomy tightrope procedure. Wishing you a speedy recovery!

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@lkd

I too had the Stabylx done 15 months ago and mine wasn’t as successful as others. Dr. told me that I was his 7th patient that was having trouble and that he quit doing the Stabylx because there is a design flaw. My hand is constantly in pain and slightly swollen. I had a steroid injection 4 mos. ago and what a relief it was, but it wore off. Had another injection about 10 days ago with zero relief. He did say that if I wanted he would take it out and do the same procedure you had but I am scared to do it because he said I will lose ROM which I currently have full ROM. My recovery from the Stabylx was long and hard and not thrilled about going thru all that again. I actually regret doing the first surgery. I am interested in how your recovery goes because there is going to come a point when the pain can’t be managed and I will need to make a decision on having it removed and doing the Trapeziectomy tightrope procedure. Wishing you a speedy recovery!

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I did not have the Stablyx done first, but did have the trapeziectomy (remove trapezius bone) and tightrope in both hands. My left trapezius was almost gone anyway from arthritis wear. I have greater range of motion than before the surgeries, no pain and recovered more strength and range of motion than the hand therapist predicted. I cannot say enough good things - I was discharged from care at 12 weeks, able to do all my activities of daily living, fully recovered at 6 months - read above about protecting my hands during heavy use by using braces/splints. I figure I need them functioning for at least another 20-25 years.
Sue

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@lkd

I too had the Stabylx done 15 months ago and mine wasn’t as successful as others. Dr. told me that I was his 7th patient that was having trouble and that he quit doing the Stabylx because there is a design flaw. My hand is constantly in pain and slightly swollen. I had a steroid injection 4 mos. ago and what a relief it was, but it wore off. Had another injection about 10 days ago with zero relief. He did say that if I wanted he would take it out and do the same procedure you had but I am scared to do it because he said I will lose ROM which I currently have full ROM. My recovery from the Stabylx was long and hard and not thrilled about going thru all that again. I actually regret doing the first surgery. I am interested in how your recovery goes because there is going to come a point when the pain can’t be managed and I will need to make a decision on having it removed and doing the Trapeziectomy tightrope procedure. Wishing you a speedy recovery!

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Your comment and questions are the reason I started this thread on the Stabylx implant. There is so little post op recovery data available on the Stabylx that I wanted to improve this deficit. While this thread is strictly anecdotal information, it is as accurate as I can make it. My surgeon did the revision on 9/4/21 and at this date, 10/25/21, I am out of the rigid splint and wearing a soft splint, the Comfort Cool brand. I am at post op day #31. There is of course healing process discomfort( mostly incisional and some related incisional area numbness that I am told is transient) ongoing but the two procedures could not have been more different in terms of outcome. Range of motion recovery so far has been exemplary and exceeded my expectations in terms of anticipated, perceived discomfort and speed of recovery. How much range of motion you recover will, of course, depends on you and your degree of pre op disease and disability. I am looking forward to having my other Stabylx implant removed and having the same procedure done on my right thumb (which after 26 months is still bothersome and more painful than the newly revised left side) I wish you well in your decision.

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@sueinmn

I did not have the Stablyx done first, but did have the trapeziectomy (remove trapezius bone) and tightrope in both hands. My left trapezius was almost gone anyway from arthritis wear. I have greater range of motion than before the surgeries, no pain and recovered more strength and range of motion than the hand therapist predicted. I cannot say enough good things - I was discharged from care at 12 weeks, able to do all my activities of daily living, fully recovered at 6 months - read above about protecting my hands during heavy use by using braces/splints. I figure I need them functioning for at least another 20-25 years.
Sue

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I do not recommend the Stabylx implant but I do highly recommend the Trapeziectomy w/ the Arthrex mini tightrope procedure for this very painful, arthritis condition of the thumb. Thanks for your input.

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@sueinmn

Thank you for the encouraging update. I have been a big believer in the minitightrope since I had one done 5 years ago and the other hand last year. I have great use, no pain except after doing something dumb and have given it quite a lot of abuse with lifting kids, gardening and home repairs, all without relapse. I do wear my hard splint for really heavy chores like moving rocks and shovelling dirt. At my hand therapist 's suggestion, we did not do a final cut down on the hard splint as healing progressed. It extends 4" beyond the wrist and provides a lot of support. For light support in repetitive chores like sewing or pruning I wear Cool Max CMC thumb splints made of neoprene.
Sue

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Please see my most recent post. Thank you for your kind comments.

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Hello Everyone. So glad I found this forum . I am 50 years young and had my Stablyx implant surgery on 7/7 so about 4 months post op. I had been dealing with significant pain in my left thumb joint for a couple years . Eventual X-rays and MRI showed a large bone spur and significant deterioration of the joint . 1st option from the dr treating me was to perform an arthroscopic procedure to remove the bone spur and “tighten up” the joint . While at first that sounded good I was not comfortable that the procedure was the right 1st procedure. A 2nd opinion from another Ortho group said that the mini tightrope procedure would be the most appropriate. His opinion was the arthroscopic procedure would not fix the unstable joint . I was not happy with that answer either as I really wanted to avoid the removal of the trapezium. I am (was) an avid golfer and enjoy working out but this injury had really stopped me in my tracks . More research led me to the Bio Pro implant. The company referred me to a UC Davis hand surgeon in Sacramento Ca where I live . After consulting with him I ended up deciding on the Stablyx for various reasons . Overall I am pleased with the surgery . Pain I would have due to the bone spur is gone but I always have a dull ache and after basic yard work hand gets pretty angry and swollen. I am still in hand therapy 1x per week . I started Iontophoresis treatment this week. Total of 6 treatments to reduce swelling and discomfort . Hoping this will get me to a point where I can start playing golf again . I will continue to post on my progress . Larry

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@ledgar

Hello Everyone. So glad I found this forum . I am 50 years young and had my Stablyx implant surgery on 7/7 so about 4 months post op. I had been dealing with significant pain in my left thumb joint for a couple years . Eventual X-rays and MRI showed a large bone spur and significant deterioration of the joint . 1st option from the dr treating me was to perform an arthroscopic procedure to remove the bone spur and “tighten up” the joint . While at first that sounded good I was not comfortable that the procedure was the right 1st procedure. A 2nd opinion from another Ortho group said that the mini tightrope procedure would be the most appropriate. His opinion was the arthroscopic procedure would not fix the unstable joint . I was not happy with that answer either as I really wanted to avoid the removal of the trapezium. I am (was) an avid golfer and enjoy working out but this injury had really stopped me in my tracks . More research led me to the Bio Pro implant. The company referred me to a UC Davis hand surgeon in Sacramento Ca where I live . After consulting with him I ended up deciding on the Stablyx for various reasons . Overall I am pleased with the surgery . Pain I would have due to the bone spur is gone but I always have a dull ache and after basic yard work hand gets pretty angry and swollen. I am still in hand therapy 1x per week . I started Iontophoresis treatment this week. Total of 6 treatments to reduce swelling and discomfort . Hoping this will get me to a point where I can start playing golf again . I will continue to post on my progress . Larry

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Thanks, Larry, for your report, it is helpful to hear from someone with good results from Stablyx. I think you can expect continued improvement - I had the mini-tightrope on both hands over the past few years, and improvement continued throughout the first year post-surgery. As for the swelling, I found ice helpful after overuse, and even used it recently, almost 2 years post-surgery.
Sue

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Hi all,
I am 69, woodworker, climber for fun and exercise, and have relied on my pinch strength for most of my life - I am always holding odd-shaped items with my left hand while working on them with tools in my right. I imagine as a consequence, my arthritis struct my left hand first. After extensive research on the carpometacarpal joint function, I decided on the Stablyx implant as the most reasonable joint rebuild. LRTI, Tight Rope, Speed Spiral, were just not what I wanted. Grip strength is fine and appears to be maintained in each of these, but I needed more. I also feel that the Bio Pro produced a different joint function. Guess I want as much original function as I can get.
So, last week I had the Stablyx procedure done at UCSF. So far so good, but it's been less than a week. I'm on anti-inflamatory only, and my pain level is less than it was prior to surgery. I understand the lack of post-op data available (Why won't Mayo post its Stablyx clinical trial data?), but I had several conversations with traditional surgeons who admitted that pinch strength would be lost. That was enough for me to take a chance on this procedure.
I normally do not do blogs, but if there is interest, I can periodically update my (hopefully) progress.
GregV

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@gregv

Hi all,
I am 69, woodworker, climber for fun and exercise, and have relied on my pinch strength for most of my life - I am always holding odd-shaped items with my left hand while working on them with tools in my right. I imagine as a consequence, my arthritis struct my left hand first. After extensive research on the carpometacarpal joint function, I decided on the Stablyx implant as the most reasonable joint rebuild. LRTI, Tight Rope, Speed Spiral, were just not what I wanted. Grip strength is fine and appears to be maintained in each of these, but I needed more. I also feel that the Bio Pro produced a different joint function. Guess I want as much original function as I can get.
So, last week I had the Stablyx procedure done at UCSF. So far so good, but it's been less than a week. I'm on anti-inflamatory only, and my pain level is less than it was prior to surgery. I understand the lack of post-op data available (Why won't Mayo post its Stablyx clinical trial data?), but I had several conversations with traditional surgeons who admitted that pinch strength would be lost. That was enough for me to take a chance on this procedure.
I normally do not do blogs, but if there is interest, I can periodically update my (hopefully) progress.
GregV

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Hello Greg, Mayo Connect is not a typical blog, members are typically seeking hard-to-find information, especially on newer procedures. We have had a lot of interest in the Stablyx implant, so I really hope you will continue to report your progress, as well as any limitations you might find.
I was very interested because I am an avid quilter and gardener, but my docs didn't feel (2 years ago) that there was enough data to recommend it, so I had a second tightrope - my first was several years ago in the other hand.
Also, according to my 3 hand surgeons, it is quite typical to need surgery in the non-dominant hand first - that is the one we abuse most using brute strength to grip, while using the dominant hand for fine details.
Good luckk as you recover - and don't forget to ice!
Sue

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@sueinmn

Hello Greg, Mayo Connect is not a typical blog, members are typically seeking hard-to-find information, especially on newer procedures. We have had a lot of interest in the Stablyx implant, so I really hope you will continue to report your progress, as well as any limitations you might find.
I was very interested because I am an avid quilter and gardener, but my docs didn't feel (2 years ago) that there was enough data to recommend it, so I had a second tightrope - my first was several years ago in the other hand.
Also, according to my 3 hand surgeons, it is quite typical to need surgery in the non-dominant hand first - that is the one we abuse most using brute strength to grip, while using the dominant hand for fine details.
Good luckk as you recover - and don't forget to ice!
Sue

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Thanks! Yes, I have abused my left hand quite a bit.
I'll keep posting as I go along. We have very good surgeons here (Bend, Oregon) but they all refuse to use inserts in hands, they measure "success" solely on pain elimination without considering desired functionality, and they generally don't listen to their prospective patients - if the joint hurts, take it out.
So I went to UCSF. They listened to me and gave me options - it was my informed choice.
GregV

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